Parenthood Juggle: “One Step Enough for Me”

footprintThe funny thing about planning the course of your life is that as much as you think you know what you want, you really have no idea.  I decided to become a physician and married my husband during my first year of medical school.  He was undaunted by any potential complications my medical career could cause in our relationship or eventual family, and for me, especially after enduring recurrent questions while a student at BYU, this was refreshing and empowering.  I really had no interest in being a “stay-at-home” mom.  I knew this was not for me.  My husband assured me that we would find a balance between our careers.  He would make decisions about his career to balance my choices.  He never expressed that he thought I should work part-time or stay home with our kids when they were babies or ever.  He was content to figure this out–“one step enough for me.”

I graduated from medical school and started a residency in internal medicine.   Our first daughter was born when my residency was almost half complete.  After she was born, my thinking began to change immediately.  I could hardly imagine leaving her to go back to work.  I just didn’t really want to, but at the same time, I did not want to leave my residency unfinished with a significant student loan debt and because I still enjoyed being a doctor.  Family members and a babysitter found by divine intervention  helped take care of our baby girl.  I managed breastfeeding with a Medela pump and the help of my husband who brought my baby to call rooms on many occasions.

Life got a bit more complicated when I became pregnant the second time with 6 remaining months of back-to-back rotations at Ben Taub General Hospital’s medicine floors, ICU, and emergency room before baby #2 would arrive.  My husband took a 3-month family leave from his internal medicine residency to ease this situation, just a couple of years after FMLA became law.  I completed my residency with a 2-month old and almost 2-year old, and was ready for a break.  I still planned to take my dream job in the geriatrics department at Baylor would start in about 3 months.  During the interviews, I prayed for confirmation and received a clear “stupor of thought”.  I could NOT feel settled about taking that academic job I thought I had wanted.  Instead, I decided to work 2 shifts a week at the VA Medical Center Emergency Room and get back to work when my husband finished his residency a year later.

I enjoyed working in the ER, but also REALLY enjoyed time with my 2 little girls—parks, museums, crafts, swimming pools, double-stroller jogging…  By the end of the year, I was pretty disinterested in working very much.  My husband and I decided to seek job-share opportunities since we were both internists and accepted a position at Scott & White Hospital in their new hospitalist group.  Just before moving to Temple and starting this new job, we had our 3rd baby.  I shared that job by working very little by my own choice.  At times my husband wished for more sharing.

Soon after arriving at Scott & White, institutional financial strains made the working environment unpleasant.  We looked for another  shared job and ended up in my hometown with a physician group where I worked part-time in the clinic and hospital and my husband started a hospital-based practice.  We had 3 children at the time and I wondered again just how this would work.  My husband prepared a hand-drawn pre-Excel spreadsheet and color-coded the hours he and I would be working or at home.  We rotated the working and kid responsibility several days a week.  I have come across the spreadsheet now and then and laughed at our naivete because it was a harder juggle than we imagined.  All the same, we did this for a couple of years before we realized that the overhead costs of my outpatient practice were unrealistic.  I bid my patients farewell, and went back to “sharing” Robert’s hospitalist job, pretty close to the time our 4th daughter was born so once again I shared by working very little.

After several  long “maternity” breaks, I longed for some consistent work…but not too much.  I began seeing patients one morning each week at an indigent care clinic operated by the local hospital.  I enjoyed this very much for a few years.  Robert arranged his work schedule to free up Tuesday mornings so he stayed home with the little ones while I worked my 4-5 hours.  I was more than content with this balance.  Even when he took a new job himself at a wound care center, he negotiated Tuesday mornings off from the beginning.

Eventually, the hospital found a full-time doctor to work at the clinic so my contract ended and I had summer vacation with 5 kids at home.  I was happy to have no work for those few months until school started back up and I started to panic.  Even though I had worked very little for several years, working SOME was definitely part of my identity and I needed to do some doctoring.  My husband encouraged me to pursue my left-behind interests in geriatrics and hospice care.  I began seeing nursing home patients for a local doctor and working 2 days per month at an inpatient hospice.  My youngest child (daughter #5) was the only one left at home, and the work was just the right amount.   As her kindergarten year approached, I began rotating one week each month at the inpatient hospice unit and then became an associate medical director, supervising an outpatient hospice team.  I saw home hospice patients in their homes and obtained board-certification in hospice & palliative medicine through an alternate pathway by documenting 800 hours of direct hospice patient care and passing the certification exam.

This is what I still do today–10-30 hours a week while my kids are in school, and I absolutely love what I do.  I worked hard through medical school and residency for my M.D. and have maintained and obtained board certification in internal medicine and hospice & palliative medicine.  Looking back I can see that my husband was the key to balancing it all.  I chose to spend more time at home with my five daughters than I ever imagined I would tolerate and loved it.

He never questioned my plans, but supported my decisions.

He took a family medical leave to help me through some difficult residency rotations.

He came up with the hospitalist job-share idea.

He arranged his work schedule to stay home on Tuesday mornings while I worked at the clinic.

And when my indigent care clinic opportunity dried up, he encouraged me to make some contacts which led me to the work I do today which is rewarding beyond my hopes.

After almost 22 years of imperfect marriage, I think we got the balancing act right. 

-Submitted by Karin

See all the Parenthood Juggle guest posts here.  Go here for this guest post invitation.  Submissions should be sent to (please see our guest post guide).